NPI | 1003135815 |
---|---|
Entity Type | Organization |
Authorized Contact | VICTORIA AKACHUKWU Owner 409-201-1964 |
Organization Subpart ? | No |
Primary Taxonomy | 111NR0400X (Licence: TX 109921) |
Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: TX 109921) |
283X00000X Rehabilitation Hospital (Licence: TX 109921) | |
Enumeration Date | 2010-05-19 |
Last Update Date | 2010-09-30 |